Improvement of non-paraneoplastic voltage-gated potassium channel antibody-associated limbic encephalitis without immunosuppressive therapy.

Abstract

We describe a 61-year-old patient with clinical evidence of limbic encephalitis who improved with anticonvulsant treatment only, that is, without the use of immunosuppressive agents. Three years following occurrence of anosmia, increasing memory deficits, and emotional disturbances, he presented with new-onset temporal lobe epilepsy, with antibodies binding to neuronal voltage-gated potassium channels and bitemporal hypometabolism on FDG-PET scan; the MRI scan was normal. This is most likely a case of spontaneous remission, illustrating that immunosuppressive therapy might be suspended in milder courses of limbic encephalitis. It remains open whether treatment with anticonvulsant drugs played an additional beneficiary role through the direct suppression of seizures or, additionally, through indirect immunomodulatory side effects.

• Authors: Heidemarie Gast, Kaspar Schindler, Werner J Z'graggen, Christian W Hess
• Journal: Epilepsy & behavior : E&B (Epilepsy Behav) Vol. 17 Issue 4 Pg. 555-7 (Apr 2010) ISSN: 1525-5069 [Electronic] United States
• PMID: 20163992 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright (c) 2010 Elsevier Inc. All rights reserved.

Chemical References

• Antibodies
• Potassium Channels, Voltage-Gated
• Fluorodeoxyglucose F18

Topics

• Antibodies (therapeutic use)
• Electroencephalography (methods)
• Fluorodeoxyglucose F18
• Humans
• Limbic Encephalitis (diagnostic imaging, drug therapy, immunology)
• Male
• Middle Aged
• Positron-Emission Tomography (methods)
• Potassium Channels, Voltage-Gated (immunology)